Immediate HE

[utep99]

Last week I was released from The VA Hospital in Dayton Ohio, I am trying to figure if there is a issue to worry about. within 12 hours I went from normal to a 198 Brain Ammonia level. My wife took me to the ER where they began treatment and kept a 24 hour watch on me. After three days I came around but still suffer some minor issues. The question is that this attack had a chess rating of 7 or 8. 9 is comatose. I still have no memory of what happened prior to my being taken to the ER or for three days I was in the ER. I know I reacted to pain so I was NOT comatose. However I have done some reading that after such a attack you have a 58.2 percent of mortality within the year. My Meld according to their tests is only 14. So I must ask what in the world happened. Not only was it a HE attack but I asperated and ended up with a lung infection. My wife and I believe this is the closest to dying I have ever been. Any insight into this. My Pugh exam is B7.

[nash2 Partner]

Well that was an experience. Ammonia is tough as it can be highly volatile. Certainly a cause to be wary. This is just speculation, of course, but the function that can change the quickest for most people is how their gut is working. A significant change in diet or somehow getting some new bacteria that alter the bowel operation can act quickly. There are certainly things you can ingest that alter the actual chemistry of the liver too but if I had to bet I'd guess your colon became alkaline instead of acidic and dumped ammonia into your blood stream. Liver patients do live on a narrow ledge so small changes can have large impact. Not helpful but maybe something else to consider.

Wayne

[RavensongNH2018]

I have had 3 bouts of hepatic encephalopathy. The first was by far the scariest because, like you, i had no memory of the three hours prior to hospital admition. Each time was due yo a concentrated amonia level in my blood stream. I take Lactulose 3X's daily to prevent future build ups, but it doesnt seem to be working as well as it has in the past. The last time (3 weeks ago) I wss informed that eith each occurrence i am becoming more susceptible. Anyone else with this or a similar experience??

[utep99 in reply to RavensongNH2018]

Yes I do. I also was placed on Lactulose 3x per day 30ml. At first very lose stools and I was having BM's about 5x per day now 2 weeks later I am at 2 to 3x bowls per day some solid and some lose. However I have had very good warnings when a BM was coming and can control them to a pretty high level.

[RavensongNH2018 in reply to utep99]

Wish that it worked as well for me!! Even with Miralax I am having only 2 - 3 BMs per week. I've had a lowerGI and a GI emptying study. They say my stomach is slow, but once digested food hits the intestines, it slows down to a crawl. My Endocrinologist believes that it is neuropathy that has slowed everything down. I drink a lot of water and eat fiber rich foods, no gluten and stay away from processed foods and take Amatiza. Two blockages that required medical intervention within the past 7 months. I'm petrified that its going to keep happening.